Methods

Areas under summary receiver operating characteristic curves (AUROC), sensitivity and specificity were used to examine the accuracy of the APRI for the diagnosis of hepatitis B-related significant fibrosis and cirrhosis.

Heterogeneity was explored using meta-regression.

Results

Nine studies were included in this meta-analysis (n=1,798).

Prevalence of significant fibrosis and cirrhosis were 53.1% and 13.5%, respectively.

The summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.79 and 0.75, respectively.

For significant fibrosis, an APRI threshold of 0.5 was 84% sensitive and 41% specific.

At the cutoff of 1.5, the summary sensitivity and specificity were 49% and 84%, respectively.

For cirrhosis, an APRI threshold of 1.0-1.5 was 54% sensitive and 78% specific.

At the cutoff of 2.0, the summary sensitivity and specificity were 28% and 87%, respectively.

Meta-regression analysis indicated that the APRI accuracy for both significant fibrosis and cirrhosis was affected by histological classification systems, but not influenced by the interval between Biopsy & APRI or blind biopsy.